Atrial myxoma: anatomy, presentation and surgical treatment
THE CONTEXT
Atrial myxomas most commonly arise in the left atrium and may produce obstructive cardiac findings, embolic presentations or systemic symptoms.
Location and morphology
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Location and attachment: Single or multiple polypoid tumours most commonly arise in the left atrium, attached by a pedicle to the interatrial septum.
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Consistency: Tumours are usually gelatinous but may be solid or calcified, with superimposed thrombus.
Examination and detection
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Heart sounds and murmur: The first heart sound is usually loud. A mitral stenosis murmur and a variable diastolic tumour plop may occur as the mass prolapses through the mitral valve.
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Detection: Echocardiography may detect the tumour incidentally or during investigation of pyrexia, syncope, arrhythmias or emboli.
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Systemic presentation: Malaise and features resembling a connective tissue disorder, including a raised erythrocyte sedimentation rate, can occasionally occur.
Treatment and recurrence
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Treatment: Surgical excision is used.
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Recurrence: Fewer than 5% of tumours recur if the pedicle is removed.